International Liaison Committee on Resuscitation: COVID-19 consensus on science, treatment recommendations and task force insights

Abstract

Consensus on Science and Treatment recommendations aim to balance the benefits of early resuscitation with the potential for harm to care providers during the COVID-19 pandemic. Chest compressions and cardiopulmonary resuscitation have the potential to generate aerosols. During the current COVID-19 pandemic lay rescuers should consider compressions and public-access defibrillation. Lay rescuers who are willing, trained and able to do so, should consider providing rescue breaths to infants and children in addition to chest compressions. Healthcare professionals should use personal protective equipment for aerosol generating procedures during resuscitation and may consider defibrillation before donning personal protective equipment for aerosol generating procedures.

Incidence and outcome of out-of-hospital cardiac arrests in the COVID-19 era: A systematic review and meta-analysis

“… 27 Although likely underreporting and/or identification of SARS-CoV-2 virus, the overall low prevalence of confirmed COVID-19 cases among OHCA during the pandemic suggests that any concerns regarding bystander CPR may be unwarranted especially in jurisdictions wherein risks of community transmission may be minimal. It should be noted, however, that CPR has the potential to generate aerosols 28 and safety of bystanders and pre-hospital healthcare workers is equally important. Community education, advanced healthcare planning and people wearing bands to indicate their wish not to receive CPR may go a long way in promoting dignity and comfort of the person who has suffered an OHCA and who has a poor chance of survival even outside a pandemic.…”

Neurological Outcome of Chest Compression-Only Bystander CPR in Asphyxial and Non-Asphyxial Out-of-Hospital Cardiac Arrest: An Observational Study

“…suggest that, as long as the COVID-19 pandemic persists, lay rescuers should consider CO-CPR in adult cardiac arrest. 37,38 Furthermore, in the case of non-household bystander, a face mask or cloth covering the mouth and nose of the rescuer and/or victim should be also considered. 37 However, COVID-19 may be responsible for acute respiratory distress syndrome (ARDS) requiring mechanical ventilation or even extracorporeal membrane oxygenation (ECMO).…”

What is the Impact of the European Resuscitation Council Covid-19 Guidelines on Resuscitation Quality – A Manakin Study

“…However, data from severe acute respiratory syndrome in 2003 and our existing knowledge on the transmission of SARS-CoV-2 indicate that aerosol generating measures during resuscitation such as chest compressions, mouth-to-mouth-and bag-mask-ventilation may be associated with a relevant risk of infection and subsequent morbidity and mortality for medical staff performing resuscitation [6][7][8] . Prioritising rescuer safety given the uncertainty of risk of COVID-19 infection to rescuers, ERC guidelines were adapted during the Covid-19 pandemic with the primary focus on the best possible protection of medical staff, protection of colleagues and bystanders, acknowledging that there might be delays in some interventions 9 . Table 1 summarizes the main differences in the recommendations for resuscitation between Covid-19 guidelines and ERC recommendations 2015 [4][5]9 .…”

“…Prioritising rescuer safety given the uncertainty of risk of COVID-19 infection to rescuers, ERC guidelines were adapted during the Covid-19 pandemic with the primary focus on the best possible protection of medical staff, protection of colleagues and bystanders, acknowledging that there might be delays in some interventions 9 . Table 1 summarizes the main differences in the recommendations for resuscitation between Covid-19 guidelines and ERC recommendations 2015 [4][5]9 . All personnel not immediately needed should keep their distance from the patient and remain protected Legend: ERC=European Resuscitation Council; Covid-19=Corona-Virus-Disease 2019; PPE= personal protective equipment; BLS= Basic-Life-Support; CPR=Cardio-pulmonary Resuscitation; HME=heat and moisture exchanger lter; HEPA=High E ciency Particulate Air lter However, due to the rapid progress of the present pandemic, these recommendations were published without evidence-based knowledge on their impact on quality of resuscitation and the subsequent potential effects on outcome of the patients 9 .…”

“…Table 1 summarizes the main differences in the recommendations for resuscitation between Covid-19 guidelines and ERC recommendations 2015 [4][5]9 . All personnel not immediately needed should keep their distance from the patient and remain protected Legend: ERC=European Resuscitation Council; Covid-19=Corona-Virus-Disease 2019; PPE= personal protective equipment; BLS= Basic-Life-Support; CPR=Cardio-pulmonary Resuscitation; HME=heat and moisture exchanger lter; HEPA=High E ciency Particulate Air lter However, due to the rapid progress of the present pandemic, these recommendations were published without evidence-based knowledge on their impact on quality of resuscitation and the subsequent potential effects on outcome of the patients 9 . Furthermore, a valid evaluation based on data from registries will be possible only in the remote future.…”